Patient Sedation Experience Survey

Dr Kate Stewart | Dental Sedation

We greatly value your opinions and would like to know more about your experience.
Please take a few moments to answer the following questions.

Pre-Treatment

1. How satisfied are you that you felt fully informed regarding what to expect? Did you receive all the information necessary to understand the planned procedure?

Poor

Satisfactory

Good

Excellent

Treatment & Procedure

2. Did the sedation meet your expectations?

Poor

Satisfactory

Good

Excellent

3. Please rate your comfort level during treatment. Did you feel relaxed throughout the procedure?

Poor

Satisfactory

Good

Excellent

4. How would you describe your memory of the procedure?

Full recall

Lots of memories, slight anxiety

Some awareness, felt relaxed

No memories

5. Would you recommend sedation to friends and relatives if they were to have a similar procedure?

YES

NO

6. Overall, how would you rate the sedation service provided by Dr Kate Stewart?

Poor

Satisfactory

Good

Excellent

Additional Comments

Please offer any additional comments or suggestions regarding your visit.

I am happy for my anonymised comments to be used for marketing purposes (e.g. published on the website or in promotional materials). Uncheck this box if you would prefer your comments not to be used in this way. Your personal details will never be shared.

Your Details

Optional — your details will not be shared with any third party.

Name:

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Thank you for taking the time to share your feedback. Your input helps us continually improve our service.

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Thank You

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We are grateful for your time and for trusting us with your care.